The CLASS program has ended in failure even before beginning, with the administration finally admitting that it was unworkable, just as prophesied by Paul Ryan and other Republicans.

Somewhere there is a museum of perpetual motion inventions. Likewise, CLASS seems to me a perfect example of the quixotic liberal quest to invent the free lunch. Democrats fought with arithmetic to the bitter end, but in the end arithmetic won, and it was revealed that, as always with the free-lunch skunkworks, the real long game for CLASS was to raise more taxes and wrest more of our freedom and money away from us and into the hands of government. The promise, of course, was that this was a gift to us of super-competent technocrats who, now at last fully in charge, could fix things for “us” that only government could fix. Politics as usual.

Like this:

Related

147 Responses

"the real long game for CLASS was to raise more taxes and wrest more of our freedom and money away from us and into the hands of government"But mostly to raise taxes. But seriously, CLASS sounds fine, at least as described by Katherine Sebelius. But why does it need to be a government program? Why not just provide a tax exemption for companies offering CLASS-style insurance, or create it as a GSE (which, as history shows, can cause problems, but they can't levy taxes). I would prefer the government ensure the long-term sustainability of Medicare and SS before it's starts forwarding efforts like CLASS (which are doomed, anyway, based on requiring voluntary participation in the midst of an ongoing recession).

But really, provide a tax incentive for insurance companies to offer CLASS style insurance, perhaps with small available government subsidies to cover a broader selection of people . . . I can think of lots of other ways to approach this.

Jonathan Cohn has an interesting post up regarding the CLASS act.The official budget estimates for CLASS suggested it would save money in the first ten years, accounting for about half of the deficit reduction that the Affordable Care Act was supposed to yield during that time. But the estimates for CLASS were never that reliable. More important, after those first ten years, CLASS was likely to pay out more in benefits than it collected as premiums. For these reasons, conservatives like Peter Suderman who criticized CLASS as unsustainable were right to raise alarms, while liberals like me were wrong to ignore them. But making long-term care insurance a mandatory part of the Affordable Care Act would have made the health care reform bill even more complicated and, potentially, controversial. So the law's sponsors decided to make the program voluntary — and called it the Community Living Assistance Service and Supports (CLASS) Act.They hoped to boost enrollment (and attract younger, healthier people) by selling policies through the workplace and using extensive outreach, among other things. But early on, Richard Foster, the official actuary for Medicare and Medicaid, warned that the plan was unlikely to work – that the enrollment would still be too low to sustain the program.But if the CLASS Act had a potentially fatal design flaw, shouldn’t we assume the Affordable Care Act has the same one? No – precisely the opposite is true. The sustainability of CLASS would not have been in such question if everybody had to sign up for it. In other words, if long-term care insurance were subject to an individual mandate, old and sick people would not have been the only people enrolling.

Re: Richard Foster — the medicare actuary. I worked with him a couple of times. He is, without a doubt, the most dedicated public servant I have ever met. If you see him quoted or his name on a report, it's as good as gospel IMO.

Re the Cohn argument, at least we will know, then, that the left is fibbing if they claim the mandate is not critical.More broadly, I don't know why we shouldn't infer that the side that was completely wrong about CLASS is completely wrong about the rest, too.

I'll see if I can find the link, but I was reading something the other day that noted that the mandate penalty might not much of a deterrent because it's too low (and unenforable — if you don't pay the penalty there are, well, no penalties). People are going to run the numbers and decide it makes more sense to pay the penalty and go uninsured until/if they get really sick. insurance death spiral.

The person who is really vindicated is Paul Ryan, as he pointed out this issue in the health care summit of 2010."Now, what's the true 10-year cost of this bill in 10 years? That's $2.3 trillion.It does couple of other things. It takes $52 billion in higher Social Security tax revenues and counts them as offsets. But that's really reserved for Social Security. So either we're double-counting them or we don't intend on paying those Social Security benefits.It takes $72 billion and claims money from the CLASS Act. That's the long-term care insurance program. It takes the money from premiums that are designed for that benefit and instead counts them as offsets. "Rep. Paul Ryan on health inflation at White House health summit

Kevin Drum had a good post about this:What happened here is that government worked exactly the way it ought to. The CLASS Act was passed in a fog of rosy estimates and emotional appeals (it was one of Ted Kennedy's longstanding priorities), and the Department of Health and Human Services immediately began the detailed work of writing the implementing regulations to get it up and running. And guess what? They did their work honestly and conscientiously. Even though it was a liberal program promoted by a longtime liberal icon, HHS analysts eventually concluded that its conservative critics were right and the program as passed was flawed. So they killed it. And most of the liberal healthcare wonks that I read seem to agree that, unfortunately, HHS was right. So yes, you were right that it wasn't going to work as it was legislated, but at least an honest–not partisan–assessment was made of it and it ended up being scrapped for the right reasons. Government really does work every once in a while! 🙂

Mich, Drum says:What happened here is that government worked exactly the way it ought to.It seems to me that Drum has it exactly backwards. What happened here shows exactly what is wrong with they way our government works. Far from being passed "in a fog of rosy estimates and emotional appeals", legislation ought to be passed as the result of sober estimates and reasoned consideration. And far from relying on HHS to undo the folly of congress, unelected bureaucrats ought not even be in a position to essentially veto legislation duly passed by our elected representatives (as bad as that legislation may actually be.)We may have dodged a bullet, but I don't see this as an example of government working as it ought to.

The actuary said something even worse, that there were not now, nor would there be in the future, enough working age adults in the. Oh try to keep the program sustainable if the ALL enrolled or were forced to enroll. The fact that this was know before it was passed demonstrates the DEEP cynicism of the government in that it was used to offset costs elsewhere and to create dependency.

Keep in mind that the Obama administration didn't due this voluntarily. It's the result of an amendment that Senator Judd Gregg put into the initial law. More fundamentally, the revenue assumptions from CLASS were central to the way that the CBO score was gamed originally to provide the argument that the ACA "paid for itself" and "reduced the deficit". Neither is true, and people like Paul Ryan pointed that out at the time. It costs more to cover more people.This episode also points to the ongoing evolution that is "We have to pass the bill so that you can find out what is in it" as former Speaker of the House Nancy Pelosi put it.

Keep in mind that there were a lot of people on the left who thought this bill left a lot to be desired also. A lot of us actually said, hey this won't work, but it might lead to single payer when it fails and costs keep rising.

Obama will veto repeal of CLASS.How is this in anyway defensible? Is he hoping to preserve it in case he comes up with a better lie that would show its sustainable? This is even more cynical than its initial inclusion!

a lot of us on the right thougt/think the real purpose of Obamacare was to "collapse the system"I never had that feeling. I read so much material at the time about the back room deals to actually preserve the current system that I really believe he thought he could come up with a working plan similar to MA. Once some of us realized what was going on, we believed it would ultimately fail, and then we'd be forced to pick up the pieces and begin all over. I worked with OFA during the debate and believe me, they shut up anyone who asked too many questions about what the hell was going on and, it wasn't some grand plan to undermine themselves or the bill. If anything they believed in what he was doing.

"a lot of us on the right thougt/think the real purpose of Obamacare was to "collapse the system" which would then result in single payer as the "only viable solution.""The real purpose of the health care reform act is to move the system in the direction of a system that is sustainable long-term, which the current system is not. Logic dictates that such a system will be single-payer & that everyone will have to contribute, but implementing such a solution now is a political impossibility. By taking incremental steps we'll spend more than we should to get where we're going, but there aren't many alternatives.

Troll McWingnut writes"Obama will veto repeal of CLASS.How is this in anyway defensible?"but the article to which he links states – in the lead sentence:"President Obama is against repealing the health law's long-term care CLASS Act and might veto Republican efforts to do so"Emphasis on might.How is characterizing 'might' as 'will' in any way defensible?

If he thinks it's really awesome and just hasn't been given a chance, I could see how he would think it's defensible. But it's not really facing facts that the program as constituted simply isn't going to work, and ACA should have been a redefinition of Medicare benefits with an expansion in ages covered (children and people over 55, for example) with an emphasis on supplemental coverage to avoid death panel nonsense, talk about vouchers for supplemental insurance for the poorest among us. And then you worry about all this other crap later.

I disagree that "logic dictates" single payer. Some argue that healthcare is a right and will therefore state that logic dictates single payer. I will argue against the idea that healthcare is a right. I might even argue that healthcare is a commodity.What's indefensible is to claim that logic dictates one conclusion.

"By taking incremental steps we'll spend more than we should to get where we're going, but there aren't many alternatives."Sure there is/was. Expand Medicare to cover kids and people slightly younger than it does now, with very mild revenue enhancements. Establish that precedent–mild, inoffensive expansions of the existing system. Establish the precedent, come back in a little while.

"The real purpose of the health care reform act is to move the system in the direction of a system that is sustainable long-term, which the current system is not."How would one defend the proposition that the system is not sustainable without Obamacare? Is health care going to cease to exist and be available?I don't think so.

Mr. McWingnut: I think "logic dictates" means that if costs are to be controlled on a national level, as a portion of GDP, then single payer is the best way to do that. Of course, I agree that logic doesn't dictate one single conclusion. Clearly, there are other ways to control healthcare costs, not all of them practical.But, from a funding standpoint, national healthcare has everybody enrolled, so has the largest possible pool to draw from, and thus is the most financially sound way to get everybody healthcare . . . of some kind. Of course, the devil is in the details and no approach that's been advanced has been limited to single payer. Clintoncare had a great deal of micromanagement of the healthcare industry and individual doctors that had nothing to do with single-payer.But you have to confess that logic dictates that I'm awesome. Logic dictates it!

"Is health care going to cease to exist and be available"Not as long as I can buy bandaids and aspirin. Everything else is just gravy.Plus that by the fact illness doesn't mean bloodletting or holes get drilled in my head to let the demon spirits out, and I'm great.

"How is characterizing 'might' as 'will' in any way defensible?"The article unequivocally says that Obama opposes repeal, even though his own administration has declared it dead after a year and a half of mighty struggle to bring it to life. This is the ideological intransigence and arrogance of Obama. From his response, we can fairly and indeed reliably conclude that CLASS was coopered up and rammed into law without regard to whether it was viable as ostensibly constituted, because now that it has proven not to be viable, Obama opposes repeal anyway. What can we conclude but that it was and is a Trojan Horse, and that Obama will now look for ways to shore it up with more taxes and perhaps more mandates and regulations? It's the same old same old Democrat iron law of government expansion: when we have fleeting majorities, we will impose vast new expansions of government, bureaucracy, and taxes, and upon passage they become inviolate — indeed more inviolate than the Constitution itself — and it makes no difference if they are complete failures, because failure just means we have to patch things up with more of the same.

"I'll let you be the one to tell Americans that Medicare and Social Security have been complete failures."I'll let you tell the American people that there's never been a new "progressive" government program, department, project, or scheme that has failed.

Here is what the claim that health care without Obamacare is unsustainable means: peope desire to consume health care goods and services in unlimited amounts, and infinite consumption cannot be paid for through free markets.Guess what, it can't be through government, either. That's really the long and short of it.

I'll let you tell the American people that there's never been a new "progressive" government program, department, project, or scheme that has failed.I didn't make that claim. You're the one making broad claims of failure, not me.It's pretty awesome how we run up huge unfunded liabilities in medicare, wars, tax cuts, then crash the economy but rescue the banks and then try to saddle the middle class, unemployed and seniors with the bill by saying sorry, you're on your own now. Too bad you didn't make the right choices in life, or you know, "shit happens". It's my belief that most of these so called failures can be saved and strengthened if we put our heads together. It's clear though that most of you don't think it's worth it. You're much more interested in blaming liberals for every ill that ails us……………too bad the majority of the American public doesn't agree with you.A new CNN poll:Providing federal money to state governments to allow them to hire teachers and first responders 75% approve Increasing federal spending to build and repair roads, bridges, and schools 72% approve Increasing federal aid to unemployed workers 60% approve Increasing the taxes paid by people who make more than 250 thousand dollars a year 63% approve Increasing the taxes paid by people who make more than one million dollars a year 76% approve Which is more important — reducing the federal budget deficit, even if the unemployment rate remains high, or reducing the unemployment rate, even if the federal budget deficit remains high? Reducing the deficit 35% Reducing unemployment 61%

"Some argue that healthcare is a right and will therefore state that logic dictates single payer. I will argue against the idea that healthcare is a right. I might even argue that healthcare is a commodity." Our current system is based on the idea that healthcare is a right. For instance, emergency rooms cover patients regardless of their ability to pay. Of course, the rest of us cover the costs of the indigent when we pay for our care. I'm curious to hear the argument underlying the claim that healthcare is a commodity. Is it really supplied without a difference in quality across markets?

Lms, I most certainly do not agree with most people on these issues and almost never have. As far as making SS and Medicare/Medicaid sustainable, I didn't say it wasn't possible (though I think it is impossible to do so and grow the economy) I just think the programs are wrong and should be phased out. They, in my opinion, lead to dependency of the individual and. Irruption of the government. Even if they were sustainable and we could grow the economy, I'd still be against them.

"I didn't make that claim. You're the one making broad claims of failure, not me."You implied something very much like it, then, by citing the sacred cows of SS and Medicare, as if (a) they aren't failures, and, more pertinently, (b) they are the sum total of our big government legacy from 20th century liberalism. They aren't. CRA, Headstart, TVA, cash for clunkers … it's a long, long list of things big and small that failed but which we aren't allowed to question."It's pretty awesome how we run up huge unfunded liabilities in medicare, wars, tax cuts, then crash the economy but rescue the banks and then try to saddle the middle class, unemployed and seniors with the bill by saying sorry, you're on your own now."This is how you sweep together a whole array of frail ideological claims and package them up as a conclusory rhetoric bomb. I'll not try to deal with the rest of it, but, the fact of the matter is that there is no one but "us" to pay the bills for everything politicians promised while they were pretending to be "us." I've said it a million times: you can take away ALL of the billionaires' money, and you might pay the current deficit for one year."……………too bad the majority of the American public doesn't agree with you."Free ponies and cotton candy, and sticking some nameless "oligarch" with the bill, are always popular. I just don't understand why there is a constant resort to citing such polls as if they have anything to do with what is good policy or is just or fair.

"How would one defend the proposition that the system is not sustainable without Obamacare? Is health care going to cease to exist and be available?"I said the old system is not sustainable. I did not say the ACA makes the system sustainable, I said it is a step in the right direction. Maybe it will work, more likely it won't help enough & additional steps will have to be taken.

"Here is what the claim that health care without Obamacare is unsustainable means: peope desire to consume health care goods and services in unlimited amounts, and infinite consumption cannot be paid for through free markets."Who are these people making such claims? One of the problems with the existing system is that people are consuming too much healthcare that is not improving outcomes. One change that the ACA is pushing is to pay for outcomes rather than fee for services. That's an idea worth trying. Maybe it will work & maybe not. If it doesn't work we try something else. What's the merit in keeping the existing system that is the least efficient in the developed world?

Bsimon, in the macro sense, yes. Just like all corn is a commodity, I choose where I buy it based in part on past experiences as well as sift through as many ears as I can to ensure the quality is high. Carpentry would be another example.

"Our current system is based on the idea that healthcare is a right. For instance, emergency rooms cover patients regardless of their ability to pay."To the exten this is true, it is itself a function of federal law. So if that is what makes the system unsustainable (it still doesn't), it is federal law that makes it so."Of course, the rest of us cover the costs of the indigent when we pay for our care."That's not entirely true. There are, for exampe, charitable hospitals and institutions that absorb some of those costs. "I'm curious to hear the argument underlying the claim that healthcare is a commodity."You can debate whether and which parts of it are ecnonomic commodities. What matters is that "health care" is consists of goods and services, subject to the same economic principles as everything else. There are those who try to deny this, but it is a senseless argument.

"The article unequivocally says that Obama opposes repeal, even though his own administration has declared it dead after a year and a half of mighty struggle to bring it to life." But it doesn't say, as you reported, that he will veto the bill. Might != will. Though homonymically maybe they're similar. .

qb writes" What matters is that "health care" is consists of goods and services, subject to the same economic principles as everything else."That is not the same as being a commodity, in economic terms. Perhaps that is not what you meant..

"Who are these people making such claims? One of the problems with the existing system is that people are consuming too much healthcare that is not improving outcomes."It seems to me that the second sentence cofirms that you are one person making such a claim. Did I miss something here?"One change that the ACA is pushing is to pay for outcomes rather than fee for services. That's an idea worth trying."Perhaps so, but I don't see why a massive government takeover is necessary to try it. The purpose of a government takeover is a government takeover."What's the merit in keeping the existing system that is the least efficient in the developed world?"You can debate what is the most or least efficient system in the world. Ours is distorted by all sorts of ill-considered government regulation and intrusion. I think it would be great to role it back to a more sane market-based approach. I would thus turn your question around: what's the merit in letting the federal government take over everything including our remaining freedom instead of demanding more of it back?

"That is not the same as being a commodity, in economic terms. Perhaps that is not what you meant."It was Troll who referred to it as a commodity. To me it isn't terribly relevant whether "health care" meets a technical economists definition of a commodity. It consists of goods and services. We are in the realm of economics, and we don't get excused from it by invoking nonexistent "rights" to things others have to provide.

"It seems to me that the second sentence cofirms that you are one person making such a claim. Did I miss something here?"You did miss something. I am challenging your statement that people want to consume healthcare in unlimited amounts. I suppose you might mean that the critics who are screaming 'rationing' in reaction to any attempt to reform healthcare are proponents of unlimited healthcare. That might be a fair characterization.

QB writes"We are in the realm of economics, and we don't get excused from it by invoking nonexistent "rights" to things others have to provide." So is it fair to interpret your statement to mean that if a person cannot afford healthcare, we, as a society, should let them suffer, untreated?

"Perhaps so, but I don't see why a massive government takeover is necessary to try it. The purpose of a government takeover is a government takeover." What massive government takeover are you talking about? The ACA is little more than a guaranteed revenue stream for the health insurance industry, which just saw the size of its customer base increased by about 60%, guaranteed. Its not like the gov't is taking over the pharmaceutical industry, or taking control of the hospitals, or the medical device manufacturers. Instead, an enormous new revenue stream has been diverted to that market. [waving hands] oh no!! Socialism!! Socialism!!Government takeover!! RUN FOR YOUR LIVES!!!

"I would thus turn your question around: what's the merit in letting the federal government take over everything including our remaining freedom instead of demanding more of it back?"1) see above (what takeover)? 2) I do agree that the mandate is not the ideal solution. But as Fairlington Blade infers, a voluntary program wouldn't work. I'd prefer a solution that allows people to opt-out, with the understanding that they cannot buy coverage on a moment's notice & will thus have to pay out-of-pocket for any expenses incurred while uninsured. Perhaps someone will find a way to make such an option available. Call your congresscritter.

"Why would you assume that?"I didn't assume, I asked. He's not explaining what he means, so I'm asking for clarification. What I asked seems like one possible interpretation. What do you think he means?

""Our current system is based on the idea that healthcare is a right. For instance, emergency rooms cover patients regardless of their ability to pay.""That isnt true. Emergency rooms are required to stabilize a patient, not necessarily treat their illness. They are not required, for example, to provide chemotherapy to a cancer patient. I'm not sure you can draw the conclusion that the system treats it as a right.

"It's an insurance program, QB. I suspect that voluntary car insurance would meet an equal fate."What is an insurance program? What equal fate?"What massive government takeover are you talking about? The ACA is little more than a guaranteed revenue stream for the health insurance industry, which just saw the size of its customer base increased by about 60%, guaranteed"ACA is a government takeover; best case scenario is that it is phase 1, or the camel's nose under the tent, whichever you prefer. Obama's own advisors have said the same. I think its defenders should decide which it is, something or nothing."You did miss something. I am challenging your statement that people want to consume healthcare in unlimited amounts."In that case, you have not explained why the system is unsustainable absent the new government regime that you say is no more than a revenue stream for the insurance industry."So is it fair to interpret your statement to mean that if a person cannot afford healthcare, we, as a society, should let them suffer, untreated?"No."I'd prefer a solution that allows people to opt-out, with the understanding that they cannot buy coverage on a moment's notice & will thus have to pay out-of-pocket for any expenses incurred while uninsured. Perhaps someone will find a way to make such an option available. Call your congresscritter."That solution is simply to repeal Obamacare and, if you feel like it, the legal mandate to provide care (although that isn't even necessary if patients will be responsible for payment).

Anyone know what a double mastectomy runs these days? Prostate cancer and surgery? Open heart surgery? As an experiment in economics I think it would be interesting to drop all federal government incentives and matching dollars in a few states just to see what happens. No more employer tax credits for health coverage, no matching medicaid funds, no government requirements for coverage such as MLR, pre-existing condition requirements, no dependent age requirements….you get the drift. Wonder what would happen, a free market bonanza or everyone's worst nightmare. Keep in mind that insurance companies pay bonuses based on denying claims.

bsimon:So is it fair to interpret your statement to mean that if a person cannot afford healthcare, we, as a society, should let them suffer, untreated?"Society" doesn't do anything. Individuals do. If you as an individual think that a person who cannot afford healthcare should get it anyway, then you should give it to him.

QB, what I'm hearing is a lot of criticism of the ACA largely based on 'slippery slope' / 'nose under the tent' concerns, with no alternative proposal. I'm not interested in defending the ACA, as its not a particularly great piece of legislation – other than being a change to the current / prior system, which needs significant repair. As it stands, there's not much ground for discussion based on what you've offered so far.

""Society" doesn't do anything. Individuals do. If you as an individual think that a person who cannot afford healthcare should get it anyway, then you should give it to him." So much for 'we the people', I guess.

"QB, what I'm hearing is a lot of criticism of the ACA largely based on 'slippery slope' / 'nose under the tent' concerns,"It isn't just a slippery slope. I said quite clearly that Obamacare is a takeover. It was planned to lead to a more complete takeover."As it stands, there's not much ground for discussion based on what you've offered so far."First, I advocated reform in the opposite direction — more not less free markets. If that's not of interest to you fine, but you are the one who claimed that the current system is "unsustainable," and you've never explained that claim. Second, there's no burden on me to propose some government solution other than ACA. It is up to defenders of ACA to justify it.

scottDo you ever try to visualize what this perfect world you'd like to live in would actually look like. Do you imagine the people on the bottom rungs of the economic spectrum ever being able to afford health care? Or are you really assuming there's enough charity in the hearts of Americans to voluntarily pay for their collective surgeries and illnesses? Do we literally let the old and the infirm beg for survival? It makes me sad to think of an America like that. Most people outgrow their survival of the fittest tendencies as they get older and realize that no matter how hard we try not everyone will succeed for a whole host of reasons many of which are outside of their control. I always thought one of our best qualities was the way we work together to solve problems and take care of our own.

lms:Do you ever try to visualize what this perfect world you'd like to live in would actually look like.I don't seek to live in any kind of "perfect world". But I will say that I certainly would prefer a world in which the notions of "community" and "society" were not constantly conflated with the notion of government. I always thought one of our best qualities was the way we work together to solve problems and take care of our own."We" don't need government to "work together to solve problems". Government is needed only if some of "us" decide that others aren't "working together" to our satisfaction, and we want to force them to do what they won't do willingly.

I consider lack of health care or access to it as much of a threat to our country as a terrorist attack. It's terrible to live in fear of a calamitous health emergency without access to either the funds or insurance coverage to survive it. I don't believe a free market insurance industry will ever voluntarily provide care to extremely sick people, why would they? It's a money pit and most capitalists avoid those. And then without insurance one unaffordable mastectomy means death……….so what do we do……nothing?

lms:I consider lack of health care or access to it as much of a threat to our country as a terrorist attack.I know someone who has a rare eye disease which is essentially rendering him to be blind. He was diagnosed about 15 years ago, at the age of 35, and in the interim he has lost his ability to function normally in many respects. There is no cure and nothing that can be done to help him. He has, effectively, no access to the health care that he "needs". In what way is this a threat to the country at all, much less a threat in the manner of a terrorist attack?And then without insurance one unaffordable mastectomy means death……….so what do we do……nothing?What should "we" do about all the people in, say, Africa that cannot afford a mastectomy? Nothing?

I don't live in Africa, I live here. I don't consider myself a citizen of the world. And people live with debilitating but non life threatening diseases all the time. It's one of the reasons we have SDI, so they can survive if they're unable to work. But that's different than watching someone you love die, or even someone you barely know. I don't understand the cavalier regard for fellow Americans. TrulyI learned a long time ago I can't save everyone but we do what we can and as a country I think we're better than what a free market health industry would provide. We need to figure it out so it's not so prohibitive but at some point people just aren't able to watch their friends and relatives die because they can't afford treatment that would save them. Living in fear was my comparison to a terrorist attack. And honestly, it's worse, the fear of not being able to access the health care system is much more real for most Americans and can also be more deadly.I'm going to bed, we'll never understand each other.

lms:I don't live in Africa, I live here.So it is then possible (perhaps even necessary?) to prioritize one's desire to help those who cannot help themselves. How is it that when you de-prioritize the health of Africans because you don't live there it is perfectly reasonable, but when de-prioritize the health of Californians because I don't live there, I am displaying a "cavalier attitude" towards people that you truly don't understand?Living in fear was my comparison to a terrorist attack.So it is not that lack of health care is "as much of a threat to our country as a terrorist attack", but rather it produces a fear similar to and perhaps worse than the fear inspired by a terrorist attack? That, I suppose, is plausible. I'm going to bed, we'll never understand each other.I think I understand you pretty well. We just have a very profound disagreement about 1) our individual responsibility towards other people (although your answer to my Africa question suggests we may be more in agreement than you might like to admit) and also 2) the justice in forcing other people to behave in ways we find preferable.

That's so strange to me that you don't prioritize people in the US over people in Africa. For the same reason that I would expect my tax dollars to support a war effort when absolutely necessary or disaster relief in OK or LA, interstate roads or education, Social Security and Medicare, I wouldn't expect my tax dollars to target a specific ongoing need in a foreign country. I know we spend a certain amount every year in international aid, probably too much considering the need here, but I think we should prioritize our own citizens……..call me crazy.You may understand me, congratulations, I'm obviously simplistic to you, but you're like a foreigner to me. I see it and hear it, but can't quite believe it. I'm not trying to take money away from you to spend on me, that would be greedy. I'm saying, we all have a responsibility, especially in matters of life and death, to our fellow citizens. We're not just one big nation of rugged individuals we're a community.

lms:That's so strange to me that you don't prioritize people in the US over people in Africa.I didn't say that. I definitely do generally prioritize people in the US over people in Africa. I just don't prioritize all people in the US equally. My sense of obligation and focus is to take care of my immediate family. Then my extended family. Then friends. Then neighbors. Then those in my immediate community, extending out to a wider community. Then my state, then my country. The further the circle gets from me, and the less real the notion of actual community, the less obligation I feel and the less effort I will put in to providing aid and comfort. That doesn't mean I don't care. It doesn't mean I don't feel compassion. It just means that I have a limited capacity to help, and I need to prioritize where that help will be best utilized towards my own priorities.Now, you may prioritize things differently, and that is fine. You may feel the same obligation towards every living soul in the nation, (although I really doubt you do). But the thing is, I am not trying to tell you what your priorities should be, nor would I want the government to force you to act on my priorities. You, however, are doing precisely that to me (and everyone else who disagrees with your priorities) when you insist that "we" must do something via the federal government to implement your priorities. And I object to that, quite strongly. You may understand me, congratulations, I'm obviously simplistic to you…I didn't say that nor did I mean that, and it is wholly unfair of you to pretend that I did.I'm saying, we all have a responsibility, especially in matters of life and death, to our fellow citizens.And I am saying that my responsibility towards some stranger in High Point, North Carolina is absolutely not the same as my responsibility towards my friends, or my neighbors, or even some stranger who lives in on the other side of my town. You insist on talking about "we". I would prefer that you speak for yourself, and let me make my own decisions about where my obligations towards others lies.

I think I understand you pretty well. We just have a very profound disagreement about 1) our individual responsibility towards other people (although your answer to my Africa question suggests we may be more in agreement than you might like to admit)I didn't say that nor did I mean that, and it is wholly unfair of you to pretend that I did.The way you word your assessment of my "priorities" suggests that not only are our priorities different, obviously they are, but that mine are so simple to understand. I actually think my priorities are pretty complicated. I don't have a set of principles that defines every action or non-action I would take. Every action or responsibility doesn't have to conform to a standard I have set for myself. Life is complicated and so is our responsibility to others. We as in I believe in a collective responsibility. Obviously our responsibility toward others branches out from our family, friends, local community etc., I agree. I don't agree that it ends at some line in the sand between states, north/south, east/west or whatever border I randomly choose. It seems to me that we as a nation, with at least some sort of common purpose or identity, could come up with a plan to ensure that at least our citizens, not the world of citizens, have access to a decent level of health care.

"The way you word your assessment of my "priorities" suggests that not only are our priorities different, obviously they are, but that mine are so simple to understand. I actually think my priorities are pretty complicated. I don't have a set of principles that defines every action or non-action I would take. Every action or responsibility doesn't have to conform to a standard I have set for myself. Life is complicated and so is our responsibility to others."Well said. I will say this (unsolicited, as opinions often are) that, again, it's best that you tell other people what (and how) you think, rather than telling them what (or how) they think. Just a general observation.

lms:The way you word your assessment of my "priorities" suggests that not only are our priorities different, obviously they are, but that mine are so simple to understand.I don't see where I said or implied anything of the sort.I actually think my priorities are pretty complicated. Fair enough. All the more reason you shouldn't be tyring to foist them upon "us". If the government is going to force me to adhere to some standard of responsibility, it should at the very least be a fairly straight forward and easy to understand standard.We as in I believe in a collective responsibility.Which, in practice, means you reserve the right to force other people to adhere to your moral standards, even if they don't agree with them. I find that troublesome. As I pointed out above, my position does not prevent you from acting on your own sense of obligation, nor does it place any obligation upon you that you don't agree with. In other words, I leave you free to follow your conscience. You cannot say the same for your position.I don't agree that it ends at some line in the sand between states, north/south, east/west or whatever border I randomly choose. Its tough to square this claim with your answer regarding Africa.It seems to me that we as a nation, with at least some sort of common purpose or identity, could come up with a plan to ensure that at least our citizens, not the world of citizens, have access to a decent level of health care. The issue between us is not what "we" are capable of doing. The issue is the tools to be used in the process. I generally don't think the force of the federal government is a legitimate tool to be used. You seem to want it to be the primary tool to be used.

Kevin:I will say this (unsolicited, as opinions often are) that, again, it's best that you tell other people what (and how) you think, rather than telling them what (or how) they think.Where did I tell lms what and how she thinks? Please be specific. And no copping out by saying that you weren't talking about me, because you know you were. (I don't mind saying that I'm getting damn sick and tired of you implying that I have done something I haven't done.)And why is it that lms gets a pass on telling me what my moral obligations are?

scott, I am NOT telling you what your moral obligations are, I'm suggesting that as a nation we have a moral obligation to OUR citizens when it comes to health care. I get that you disagree, I thought that's what we were arguing about. And I clearly stated that the borders of our country hold a higher level of responsibility to me than beyond our borders. Obviously that is why I can claim that I don't feel obligated to provide health care to the entire world. I do place a high value on American citizens and am more than willing to try to find a solution that most, certainly not all, of us can agree upon. I also view health care as something that is not susceptible to normal market principles precisely because it is a matter of life and death. There is no compelling reason for an insurance company to insure someone who is either sick or old, the profit isn't there and will never be there. I doubt they would do it on moral grounds.

lms:I am NOT telling you what your moral obligations are, I'm suggesting that as a nation we have a moral obligation to OUR citizens when it comes to health care.Unless you think that I am not a part of "we", these two sentences are completely irreconcilable.And I clearly stated that the borders of our country hold a higher level of responsibility to me than beyond our borders. I know. And that is inconsistent with your claim that you do not randomly select some border at which to "draw a line in the sand".

To butt in for a minute on this eternal debate, there is a fundamental difference as to the relationship between felt moral obligations and the role of government, as well as the form of government and policy most conducive to prosperity and the availability of health care and other goods and services.There is a fundamental difference as to the relationship between government and society.And there is a difference of a lesser order (at least with a more moderate hippie like lms : ) as to the social and geographic reach of moral duties and attachments. With more immoderate hippies, there is a wider chasm, because generally speaking leftism presumes more like a universality of "rights" to sustenance and the like (I put it this way rather than the converse of moral obligation, because I think it is more accurate). But as between American conservatives and libertarians on one hand and liberals on the other, there is still a strong disagreement. To "our" side there is little meaningful sense in which the country as a whole can be viewed as our "community." Our community is something much smaller."I also view health care as something that is not susceptible to normal market principles precisely because it is a matter of life and death."Once again, this seems like a non sequitur to me. Health care consists of goods and services; ergo, by definition it is subject to normal market forces. So are food, clothing and shelter, which are also matters of life and death. It seems to me that the real claim you are making is that we shouldn't allow these matters of life and death to be subject to market forces, or something like that. But there is no way to isolate them from market forces, just as there is no way to suspend the law of gravity.

Scott, you're parsing words, IMO. You're clearly part of the "we" that disagrees with me but last time I checked you're still part of the "we" that is an American citizen. I think your claim of my being inconsistent is not credible. I clearly stated that I do not have some random border within the US that separates the worthy of community effort vs. not worthy. Beyond that, I understand that our tax dollars go to some relief internationally, some I agree with some I don't. Generally, I believe we should limit our aid to humanitarian purpose and on a very limited scale. If I have to choose between Africa and the US, I choose the US. I thought I made that clear……………If I were writing an essay and looking back at my words and possible interpretations with a lot of time on my hands, or expecting a grade like a school child, I would be more careful in my choices. Right now I'm doing 10 things at once and just jot down ideas as they pop in my head with one quick preview if I'm lucky. Forgive me for not being clear and I'll forgive you for being obtuse, lol.

I choose infernal.qb, of course it could be susceptible to market forces and then we would have even more of a two tier society, you receive health care only if you're independently wealthy once you are sick. I don't consider that a choice the free market should make for us. If you can detail a reason for the insurance industry to voluntarily, by market forces, to offer coverage to the sick or old, I'll listen.

Scott: Dude . . . "Where did I tell lms what and how she thinks? Please be specific. And no copping out by saying that you weren't talking about me, because you know you were."You were telling me what I was thinking right there, in that very sentence. Were you being ironic or do you really not get that? Or, 3rd option, am I off my nut? (always possible). Also, Scott:"(I don't mind saying that I'm getting damn sick and tired of you implying that I have done something I haven't done.)"If you (a) haven't done it and (b) I haven't said, "Scott, I'm talking about you" you can safely assume I'm not talking about you. And given what I said, you're still kinda making a lot of assumptions about what I was thinking. Truly, they were general observations meant to reinforce particular points I have made before. Because I feel fairly confident I'm right on this as a stylistic approach, and, clearly, you do too. (See what I did there?)"And why is it that lms gets a pass on telling me what my moral obligations are?"Since I wasn't addressing anybody specifically or quoting anybody, you can presume it was a general comment on not telling people how or what they are thinking, that applies generally, to anybody who bothers to read it, and me, most especially. Most, it was a pontification on my own wisdom, which is necessary, since nobody else has to the good sense to laud my brilliance for me. ;)I have a hard time reading lmsinca's observations on what she considers a shared moral obligation (although this does deserve it's own discussion) as a specific instruction to you, specifically, on what you should be doing (and a criticism of what you do not do). But if you have an observation on what you consider a stylistic approach, and have a superior way to communicate an idea instead, then share!

lms:you're parsing wordsNo, I'm not. Your two claims are entirely inconsistent. Accusing me of parsing words doesn't change it. It is a simple matter of logic. It is likely that you don't consciously want to tell me what my moral obligations are. But the implications of your position are what they are, regardless, and I think you need to come to terms with them.If American citizens have a moral obligation to do X, and Scott C is an American citizen, then Scott C has a moral obligation to do X. To assert that American citizens have a moral obligation to do X, then, is to assert that Scott C has a moral obligation to do X.This is straightforward logic. If you disagree, then explain where the above statements go wrong logically.Forgive me for not being clear and I'll forgive you for being obtuse, lol.Sorry if I am not in a joking mood, but Kevin has really pissed me off.

I think you need to come to terms with themScott, no I don't think I do. This is not a dilemma that lends itself to logic IMO. Unless you're a proven serial killer or something I would never claim to dictate your individual moral obligation, but I do believe we can have a collective sense of an obligation to our citizens to provide at least a minimum of health care coverage, I would even suggest that most of them actually pay a premium for that coverage and share the cost of care. I do not trust the insurance market to provide coverage to the sick and elderly and if you are even middle class the cost of some health care events are entirely prohibitive. I'm not questioning your personal morality, I'm questioning our collective responsibility. I don't understand why that isn't logical. I don't feel I have a personal moral obligation to spend $250k for Mary's mastectomy, but I do feel we have an obligation to provide Mary with an avenue to purchase insurance to help her receive that surgery. If Mary battled cancer 10 years ago, no insurance company in the world will offer he a policy, at any cost. This is where the government can step in and say, let's pool our collective resources and make sure our citizens have access. I think the disagreement should center around the best way to do that, but you question the obligation in the first place. I get that, that's what I'm arguing with you over, not your personal moral fabric.

kdub, buddy ole pal. I think your comment read pretty clearly as a chastisement of Scott, which after reading over the whole exchange again, I think was not very even handed. Perhaps not intended. It's inevitable in discussion and debate that everyone engages in some degree of saying someone else thinks X. It is part of communication. In general, I agree that going easy on it is a good idea, but here I think the flag throwing was a bit errant. Or as they say, "call it both ways, ref!" or "let 'em play, ref!"lms,I think you've quite skipped over an important point, which is that, if you agree (as it seems) that health care is indeed subject to market forces, the consequences of turning it over to government cannot be so easily dismissed. I also see no support for your claim that only the independently wealthy could have medical care without the government. Indeed, I'm quite certain that claim is untrue, and we prove it every day. We purchase all sorts of health care all the time without the government, and we aren't independently wealthy. Millions of other Americans do the same.Your question about insurance companies seems to me misconceived. For one thing, they have the same incentive they always have to sell insurance prospectively to people before they are sick and old. But beyond this there's no reason to look at insurance companies as the only sources of health care for people who need help. Btw, how do you explain the drug assistance programs all large drug companies offer?

"kdub, buddy ole pal. I think your comment read pretty clearly as a chastisement of Scott"Fair enough. I disagree wholeheartedly, but I expect I'm in the minority (of one) on that. Anyhow, I concede defeat and zip my lip on the topic, as it were. Tempted to say more, but at some point I need to learn to take my own advice. You know what would be great right now? Cake. Mmmm. Cake.

Kevin:You were telling me what I was thinking right there,No, I was telling you what you were doing, which was obvious for all to see. And I didn't ask you about what I said to you. I asked you about what I said to lms. Which you still haven't answered.Look, I am not going to pretend to be incapable of drawing inferences. It is insulting to me (and, frankly, everyone else here) if you seriously expect us to believe that this suggestion of yours was totally unrelated to my conversation with lms, as if it suddenly popped into your head out of the blue and you just happened to decide to throw it in on a thread that is already over a day old, while at the same time prefacing your comment with a "Well said" to lms's (false) accusation about me "assessing" her priorities as being "simple". (No such "assessment" ever occurred.) You can make these criticisms as oblique as you want by adding in your "I'm just making a general observation" qualifiers and disclaimers. What you were doing was crystal clear.But here's a stylistic suggestion of my own. If you don't want me jumping to conclusions about where your oh-so-helpful suggestions on how to interact with people here are directed, then bloody well stop interjecting them into my conversations with others.

qb, I'm not talking about a cold or ingrown toenail. I'm talking about access to life-saving surgery or cancer treatment that is enormously expensive. Most people cannot be reasonably expected to pay for that type of expense without insurance coverage. Did you know that prior to ACA 50% of people who became sick were stricken from the insurance pool? Or that people whose employers did not provide some form of coverage but had ongoing health issues could not purchase insurance? That's what I'm talking about. I'm more than willing to discuss cost sharing ideas etc. but I cannot get beyond the fact that an insurance market left to it's own devices will not provide coverage to people who are either sick or old. Your answers don't solve those problems. As I told scott, I don't believe that makes you morally bankrupt, just wrong. I see a need for a set of rules that will safeguard "our" citizens from the worst case scenario. I don't see that happening without government intervention, what form that intervention takes is worthy of argument. But if we do not agree that the need is there, what's the point in discussing solutions?

Always back to the drawing board, it's good for us. The conversation usually ends up going down some tunnel with no light at the end of it and lots of assumptions about others along the way. One of the reasons I'm still debating this issue is because of the hope that there might someday be a light for one of us, and I include myself in that hope. I still haven't heard anything that will change my mind that health care is both an obligation in some form or an almost impossible problem to solve, if we can even agree that it is a problem in the first place. So far we haven't even gotten to that milestone.

Let me say something else entirely honest. The reason I jumped on that simple-minded snarky retort is because I do feel that you, scott and qb, think that I am simple-minded occasionally, as if your arguments are superior to mine. Perhaps you don't believe that, but it is as much of an under current I feel as the one that scott believes that I think he is morally bankrupt. We probably all need to try harder to communicate. I think Kevin jumps to my defense occasionally when he probably doesn't really need to. Very noble kevin, if that's what you're doing (pure speculation on my part), but I really can take care of myself, lol.

lms:The reason I jumped on that simple-minded snarky retort…What simple-minded snarky retort? Seriously…I have no idea what you are talking about.I do feel that you, scott and qb, think that I am simple-minded occasionally, as if your arguments are superior to mine.Well I clearly think my arguments are better than yours, otherwise I would make your arguments instead. (Don't you necessarily think yours are better than mine?) But I dont' think you are simple-minded and have certainly never intended to suggest otherwise.…as the one that scott believes that I think he is morally bankrupt.I don't think that at all. (Where's the comments-nanny now?) I simply think that there are certain logical implications to your position that contradict other things you say. As I demonstrated with my logical formulation above.(From earlier)This is not a dilemma that lends itself to logic IMO.I'm not sure which dilemma you mean. We had been talking about the logical contradiction between saying American citizens have obligation X, but that American citizen Scott C does not have obligation X. But I sense here you are referring to the "dilemma" of health care itself.Either way, I have to confess that logic and reason are the only tools I posess that allow me to think and make arguments about issues. If you are declaring a certain issue to be beyond or outside the confines of logical thinking, I am at a loss as to how to proceed.

I was talking about my snarky comment not yours, and the impression I have that you and qb think my arguments are simple-minded and contradictory. And I don't see the logic in your argument that you do……..so what does that mean? In my contradictory opinion there is a difference between and individual right and responsibility and a community one and they are not always the same. I have a personal moral objection to the death penalty but I will concede that collectively it might work as a deterrent to crime. It's the same with the torture argument, I can oppose torture, and yet at the same time break my moral code and engage in it and accept the responsibility for what I have done if it saved the life of one of my children. I don't view issues in terms of X or Y or even 100% logical. It's the same way I can oppose abortion but realize that it will happen anyway and make it as safe and rare as possible. I guess I'm illogical, oh well, I'll try to live with it. My head is always full of conflicting thoughts and opinions, maybe I'm just crazy, not simple-minded (/s).

lms:the impression I have that you and qb think my arguments are simple-minded and contradictory.I do think they are often contradictory. But not simple-minded. How can I disabuse you of this impression?maybe I'm just crazy, not simple-minded Well I agree that you aren't simple-minded, so…..

How can I disabuse you of this impression?I don't think you can nor is it really necessary. Too many years of X's and Y's and ponies and rainbows from you guys (and Little Red Hens). It's not a big deal, just sits in the back of my mind and sometimes creeps into my comments.

I believe faith in God is also logical (highly so), in the most general sense in that the very structure of the universe shows evidence of intelligent design. But, I wouldn't have agreed with that 10+ years ago, so I respect the fact that many people aren't going to see it that way.

I believe in God also but I would never claim it makes logical sense or that it makes logical sense for me to believe in God but not necessarily believe the Bible or that Jesus is the Son of God. I think it's easy to separate our own personal moral code from the community obligation. It makes "logical" sense to me that if the insurance industry isn't going to offer insurance to people who are sick or old, then as a country we should try to fix that market aberration. I realize it means some sort of compromise and not everyone will actually see it as an aberration but I don't think objecting to it on logical grounds is a valid reason for not doing it. I can even, against all logic, see the validity of your argument scott, but still disagree with it. I think I'm probably just digging a deeper hole now so I better stop. See y'all later, after I take my thorazine…………jk.

Kevin:I believe faith in God is also logical (highly so), in the most general sense in that the very structure of the universe shows evidence of intelligent design.That may be, but then it isn't really "faith". Faith is the belief in something without (sometimes even despite contrary) evidence. That's why I said that faith is something apart from logic.Perhaps I am being a bit pedantic, but I'd say one might view a belief in God to be logical consequence of understanding the nature of the universe, but faith in the existence of God is not strictly logical.

Like I said, people will differ, but in some ways logic compels me. I was an atheist for a long time, so . . . while I understand the logic of atheism (as opposed to agnosticism, which posits we do not know and cannot be certain), I consider it incomplete. Like you take it all the way to final part of the trick and never flip the card over (because that's kind of what it was like, for me, but I digress). While I don't know that logic argues for a necessarily Judeo-Christian chronology, I think existence itself argues for an intelligent creative force. The rest we may take on faith. BTW, in regards to insurance, like SS or Medicare, I don't have a problem with a government role in delivering these things as an entitlement, as long as it is (a) possible and (b) sustainable. Failing those things, it's not yet time for a shared, government-delivered response. When it doubt, don't take on another entitlement.

"Perhaps I am being a bit pedantic, but I'd say one might view a belief in God to be logical consequence of understanding the nature of the universe, but faith in the existence of God is not strictly logical."That makes a great deal of sense to me. And, of course, no matter how logic may compel me to the conclusion, there is always faith involved. I can't really test the conclusion. And past the basic sense that there is clearly intelligent design in the structure of the universe (at least, in what little I know of it), everything else necessarily has an element of faith. My own experience was one where I was driven to my faith by a logical compulsion, where I suddenly saw the secret image in the Magic Eye static, and from that point forward could no longer unsee it. But of course, there is always an element of faith. I tend to believe that is a necessary part of it. I didn't mean to say belief in God was only logical, or should only be logical. Just that it's not the same thing as a belief in a giant flying spaghetti monster, or Santa Claus, certain critics of religious belief aside.

Kevin:Just that it's not the same thing as a belief in a giant flying spaghetti monster, or Santa Claus, certain critics of religious belief aside. I generally agree with folks like Dawkins on the big picture, but I can't stand the self-satisfied and condescending manner they (he, especially) take on. I've seen him (and others) in debates and actively rooted for them to get their ass kicked, despite my ultimate agreement with them.Part of that comes from a sense that they (I?) still must be missing something, because I confess that I am troubled by some of the ultimate implications of their position. The big question, which Dawkins always skirts and never addresses head on…if his materialism is correct, moral notions (and indeed the notion of free will) become untethered from reality.

"I generally agree with folks like Dawkins on the big picture, but I can't stand the self-satisfied and condescending manner they (he, especially) take on. I've seen him (and others) in debates and actively rooted for them to get their ass kicked, despite my ultimate agreement with them."While I do believe in God, now, I'm very sympathetic with that position. I was for most of my life an atheist unhappy to be on the same team as the Richard Dawkin's and Madalyn Murray O'Haire. Now I get to be unhappy to be on the same team, ostensibly, as Pat Robertson. 😉 "if his materialism is correct, moral notions (and indeed the notion of free will) become untethered from reality."Back in the day, I always felt atheism did not exclude morality, or that moral notions were untethered from reality, although this was still an article of faith. Basically, my sense was that an existence without a creator did not eliminate a natural morality from self-aware and thinking beings–which was mostly a faith-based position, a sort of "well, it doesn't, just because" but I still have a sense that the universe implies certain moral truths, whether or not we attribute them to God or nature or the powers of algebraic coefficients. That these aren't truths that are written out on stone tablets, but once that are distilled over time over generation over generation over generation.Whatever moral truths are written into the fabric of the universe (and however they got there), they're tough to reliably decode.

How awsemome. This post is like ten posts old now, and the fur has barely stopped flying.I just had to say to lms:No, I don't think you are either simple minded or crazy. I think you are very, very smart and sane. Way smarter than most of the idiot Democrats currently running our tax. Wrong about a lot, but very smart. If I thought you were a simpleton, I would not have agreed to join your rebellious, breakaway republic, now would I? Probably a fine cook and excellent card player, too."Just a question, is faith in God logical?"This could mean various things. Assuming faith in God means belief in God, it could mean, can God's existence logically be believed. It could mean, does God's existence logically follow from the evidence available to us. It could probably mean many other things, too.Belief in God certainly is logical in the first sense. Many smart philosophers and theologians have argued that the second is true as well. On this point, Romans 1 says this: "The wrath of God is being revealed from heaven against all the godlessness and wickedness of men who suppress the truth by their wickedness, 19since what may be known about God is plain to them, because God has made it plain to them. 20For since the creation of the world God’s invisible qualities—his eternal power and divine nature—have been clearly seen, being understood from what has been made, so that men are without excuse."So, the Bible says both belief in God and principles of right and wrong are logically inescapable from nature. And since the Bible says it, it is true, right?

qb, thanks but I wasn't fishing for compliments, just stating a "feeling" I get sometimes that influences my comments. It's no big deal, normally I just disappear for a few hours to cool off. :)I think where scott and I differ, besides on issues, is that he argues from an absolutist or more formal logical basis, universal truth if you will, and I don't believe moral issues can be resolved without the context of the problem we're trying to solve or the ramifications of the conclusion. He views me as being inconsistent and I view him as being rigid. If his X,Y scenario results in an intolerable (to me) solution, then I cannot accept it and it really doesn't matter to me how logical he thinks it is. A belief in God satisfies me in some inexplicable way, whether it defies logic or not doesn't particularly matter to me. It's not something that can be taken away from me through logical or absolutist argument in other words. Just another difference between humans really. Like NoVA said the other day some of us are AM and some FM.

"So, the Bible says both belief in God and principles of right and wrong are logically inescapable from nature. And since the Bible says it, it is true, right?"Well, I wouldn't dismiss it out of hand. I'm personally not a Biblical inerrancy type of person, and while I do think the principles or right and wrong are inherent in nature, I think determination of them can sometimes be a little difficult. It's not all commandments–I think a great deal of it is riddles.

lms:And I wouldn't mind if one of you recognized that mine is a legitimate debating style either.I don't have a problem with your style, but I can say that I will never accept any argument that says, essentially, X is not X, as legitimate.Again, if American citizens have obligation X, and Scott is an American citizen, then Scott has obligation X.I don't think there are any quarters in which the above formulation would be rejected. It is basic logic.I know that you are trying to draw a distinction between "collective" obligations and individual ones, but that is an incoherent distinction to me. The collective is an abstraction, not an actual thing that can "do" anything. If saying that the collective has an obligation to do something does not mean that the individuals that make up the collective have that obligation, then it has no meaning at all.How does the collective "do" anything in the absence of individuals within the collective doing it?

I don't think I actually argued that X does not equal X. I'm saying that you can't always use logic to solve problems for a collective of people. SheeshI get that you don't want to pay more to provide more, I'm saying that whatever our individual responsibilities, obligations, or moral proclivities are don't necessarily match up to the responsibilities and obligations we have to our citizens. You can't always use simple mathematical equations to solve complex problems. All you have to say is "I don't want my taxes increased or used in a confiscatory way to expand the governments role in health care". That's the bottom line and then I say, "The government is the only entity that can ensure that "our" citizens have access to the health care system and that's my goal". Easy peasy, we're done.

lms:I don't think I actually argued that X does not equal X.What you argued is that American citizens have obligation X, but that does not mean that ScottC, who is an American citizen, has obligation X. I think it means, and can only mean, precisely that.As I mentioned above, it seems that you reconcile this by claiming that collective obligations are different from individual obligations. But, again, this doesn't make sense to me, for the reasons I stated above.So I'm just asking you to explain to me…how can a collective "do" something in the absence of individuals within the collective doing that thing?

I'm not trying to take money away from you to spend on me, that would be greedy. I'm saying, we all have a responsibility, especially in matters of life and death, to our fellow citizens. We're not just one big nation of rugged individuals we're a community.The above is my point, I never argued that your formula was wrong. What we were really arguing about is the context. As I said, I completely understand where you're coming from, I just see a higher value, and it's purely a personal preference on my part when it comes to health care, on the community vs. the individual. I consider the failure of our health care system a National crisis.If I wasn't clear in my argument then I apologize. Obviously my focus on the collective in this case requires individuals to pool their resources, against their will in many cases. I agree.

lms:Obviously my focus on the collective in this case requires individuals to pool their resources, against their will in many cases. I agree. OK. So this brings me back to, and I want to reiterate, what I said way upthread and which led to the whole obligation discussion…This means you reserve the right to force other people to adhere to your moral standards, even if they don't agree with them. I find that troublesome. As I pointed out above, my position does not prevent you from acting on your own sense of obligation, nor does it place any obligation upon you that you don't agree with. In other words, I leave you free to follow your conscience. You cannot say the same for your position.

Jeezus, I'm not trying to cram some moral standard down your throat, I'm saying that in some instances our national interest supersedes the individual. Obviously, you disagree. You're the one who first used the term moral, not me. I consider it an obligation of national scale not necessarily morality. Although I admit that my own personal conscience dictates the same, I don't believe in imposing my sense of morality on others. I realize that sounds inconsistent to you but I can't really help that. As I said, that's the way I roll.

lms:I'm not trying to cram some moral standard down your throat…I think that if you use government to force people to fulfill some moral obligation that you feel, that is pretty much exactly what you are doing, whether you intend to or not.I consider it an obligation of national scale not necessarily morality.If the oblilgation you speak of is not a moral obligation, from whence does this obligation arise?I realize that sounds inconsistent to you…Doesn't it sound inconsistent to you?As I said, that's the way I roll.Perhaps it is a defect of mine to consider internal consistency and a lack of contradiction to be essential to a rational argument.

I don't think it's inconsistent to perhaps to believe that, on the whole, something is a good idea without necessarily believing it's a moral issue.I don't think we have a moral obligation to standardize road and highway conventions, such as what sign shapes mean and what color the stripes on the highway are, and what side we should drive on. However, I think that mandated standardization is, in fact, a very good idea. I also think that one can personally feel we collectively owe a debt to the greatest generation, or our senior citizens, or have a collective obligation to take care of our children without being prejudiced towards one approach (in this case, government legislation). I think most people have a sense of how we collectively ought to be (we ought to care for our sick and indigent; we ought to leave small business people alone to make a little money; we ought to stay out of the tax payer's back pocket, etc). How that should be expressed and at what level, and what our collective obligations really are, may be more controversial. "Perhaps it is a defect of mine to consider internal consistency and a lack of contradiction to be essential to a rational argument."As Kathryn Schulz point out, being wrong feels exactly the same as being right. In both cases, it feels like you're right. Similarly, I think we tend to find our own arguments rational and consistent and lacking fundamental contradiction (even if there must be caveats), even if many other people do not. Personally, I see both your arguments as internally consistent.

Perhaps it is a defect of mine to consider internal consistency and a lack of contradiction to be essential to a rational argument.Yes, I think that's exactly right. :)Scott, I think it is imperative as a nation to ensure that our population has access to health care. Call it National Security if you want. IMO the insurance industry has abused the privilege of providing access and the only way to counter that is with rules, unfortunately set by the government and paid for by tax payers, to correct the market force that has twisted and corroded that access. It's much the same as breaking up a monopoly, do you consider that a moral issue as well? Most first world nations protect their citizens from such abuse because it is in their interest to do so. Ideally we would be able to do it without adding to the deficit, I'm certainly open to that idea and as I said ideas for cost sharing, lowering costs etc. etc.

"I don't think I actually argued that X does not equal X"BTW, generally we have collective obligations that individuals are often exempted from. That is, if certain conditions are met, you have an individual duty as part as a collective obligation. If other conditions are met, then you do not have this obligation. I have to pay taxes, except on the money I may deduct from being taxed, which lowers my obligation. If I do not earn any money, I have no obligation to pay my taxes. We have a collective obligation, I would think, to provide for the defense of our country. Some of us do this through what we pay in our taxes, others provide civilian support, and still others pick up a rifle and go to war and lay down their lives. Although we share the same collective obligation, both the manner and to the degree we meet that obligation is very different on the individual level. I don't really have a sense in any case that these collective obligations represent a given set of moral strictures being shoved down my throat, but I suspect moral notions such as duty to God and country definitely play a role.

Kevin:I don't think it's inconsistent to perhaps to believe that, on the whole, something is a good idea without necessarily believing it's a moral issue.But it is inconsistent to want the government to force others to fulfill what you perceive as a moral obligation while at the same time claiming that you have no interest in imposing your sense of morality on others.It is also inconsistent to claim that American citizens have obligation X, but that ScottC, and Americn citizen, does not have obligation X.And these, of course, were the inconsistencies I have been talking about.I also think that one can personally feel we collectively owe a debt to the greatest generation, or our senior citizens, or have a collective obligation to take care of our children without being prejudiced towards one approach (in this case, government legislation).But the relevant issue is what it actually means to speak of a "collective obligation". As I said, the "collective" is an abstraction, not an actual, sentient being. It can't "do" anything. So unless by "collective obligation" you mean an obligation of all the individuals within the collective, I have no idea what you could be speaking of.Similarly, I think we tend to find our own arguments rational and consistent…Do you find the argument "American citizens have obligation X, but American citizen ScottC does not have obligation X" to be a rational, consistent argument?

Personally, I give up. As I've already conceded that scott's argument is both logical and rational and mine is inconsistent in that it places national interest above individual interest in the context of health care, you win scott. It is pointless for me to try to convince you that I have a legitimate point outside of the parameters that you have set for the debate.

lms:I think it is imperative as a nation to ensure that our population has access to health care. Call it National Security if you want. I don't want to, but I will if that is the argument you are making. What evidence is there that our national security is imperiled given our population's current (and, on historical standards, very high) access to health care?the insurance industry has abused the privilege of providing access…Providing a service that people desire is not a "privilege".to correct the market force that has twisted and corroded that access.I do not believe any such "corrosion" has occurred. Indeed, it is pretty much a certainty that people in the US generally have access to far, far more health care today than at any time in our history. This is one reason why so much is spent on health care. You can't spend money on that which does not exist. It's much the same as breaking up a monopoly, do you consider that a moral issue as well?This is a whole new can of worms that probably shouldn't be opened now, but yes. (Although not in the way or for the reasons I suspect you imagine.)

Not right now scott, I've already conceded. You win. You're rational and logical and I'm inconsistent. I'm not that interested in opening any other cans right now as I have work to do and don't have time to parse my words to your satisfaction. To debate the insurance industry again really has nothing to do with your points and so I probably shouldn't have brought it up. I only did so to make a point that a percentage of our population indeed did not have access to health care prior to ACA because of the age and health restrictions the insurance industry placed on the population and the prohibitive cost of some treatments without insurance coverage. It took government intervention to change that.

"But it is inconsistent to want the government to force others to fulfill what you perceive as a moral obligation while at the same time claiming that you have no interest in imposing your sense of morality on others."Fair enough, although it sounds like semantics, to me. Society and community will always involve some sublimation of the individual to the group. Do you think most of us have desire to impose our sense of morality on others? At some point, this is clearly acceptable, as law is frequently an imposition of moral judgement, with sometimes dire consequences for the individual whose having the shared morality of (presumably) the majority imposed on them."Do you find the argument "American citizens have obligation X, but American citizen ScottC does not have obligation X" to be a rational, consistent argument?"At worst, I find it incomplete. I do not find it to be terribly inconsistent. If I argue that $10 you already pay in taxes should go to national healthcare as opposed to defense spending, what morality am I subjugating you to? If I'm a flighty hippie chick that would prefer all my taxes go to fund NPR yet I'm still funding the gears of war, we could say that's someone else having impose their morality on me. Is there a substantive difference, in regards to the imposition of morality, between government funded healthcare and government funded defense? If not, then isn't anything funded by the tax payers or regulated by the government an example of imposed morality? Which would seem to suggest that when we say we have a collective obligation that I feel we should meet, and I would like to see us find a way to meet that obligation through the normal democratic legislative process, I'm not seeking to impose my morality on you any more than other people's morality (including yours, presumably) is already being imposed on me. Thus another way of stating it is: yes, I believe my morality should be imposed on you, just as you believe your morality should be imposed on me, if we want consider these shared obligations (and the democratic republican (as adjectives, not party affiliations) manner in which we determine them impose morality rather than just shared obligations that we arrive at via the mechanism of our constitutional democracy.

"Indeed, it is pretty much a certainty that people in the US generally have access to far, far more health care today than at any time in our history."This is true here, and it's also true in most other parts of the world. By metrics of longevity, most every place in the world enjoys better healthcare than it did 30 or 40 years ago. Additionally, the healthcare that the indigent and poor may have limited access to today, nobody had access to 50 years ago. The outrageously priced pharmaceuticals and imaging technologies and diagnostic tests simply weren't available, at any price. Until such time as medical science makes us effectively immortal and perpetually 20 years old and without colds, infections or pain, deafness or poor eye-sight . . . healthcare is going to be seen as abysmal and unfair and in rotten shape. "The poor are only living 300 years, and the average 100 year old poor person barely looks a day under 30! This injustice must be addressed!" That said, anybody who has experienced American healthcare without a lot of money to spend on it could agree that there's lots of room for improvement. So, it shouldn't be surprising that there are people trying to "improve" it.

lms:As I've already conceded that scott's argument is both logical and rational and mine is inconsistent…I know you did. I was responding to Kevin's seeming defense of your position. I was not trying to press the point further with you.

Kevin:Do you think most of us have desire to impose our sense of morality on others?Perhaps, but the trick then is to understand morality in such a way that the imposition of it is not a violation of it. Hence the attractiveness of the libertarian philosophy. At worst, I find it incomplete.OK. Consider this:Triangles have three sides, but an isosceles triangle does not have three sides.Do you find this to be merely incomplete but not terribly inconsistent as well?If I argue that $10 you already pay in taxes should go to national healthcare as opposed to defense spending, what morality am I subjugating you to?I can't know without you telling why it should. If I'm a flighty hippie chick that would prefer all my taxes go to fund NPR yet I'm still funding the gears of war, we could say that's someone else having impose their morality on me.Possibly, yes. This is an inherent contradiction of a government that ostensibly protects freedom, but funds itself via coercive methods. One reason why I hate the income tax. I don't think it would be a bad thing at all if taxpayers were allowed to select how much of their own taxes went to which government programs. (Of course, such a thing leaves us with the free-rider problem that your flighty hippie chick represents.)But all of this ultimately reduces to a discussion of the proper function of government. I, like our founders, believe that the proper role of government is first and foremost to protect the individual rights of those under its purview. To the extent that the presumed existence of individual rights assumes a certain moral standard to the exclusion of others, then I suppose one might say that this role of protecting rights is an imposition of morality on those who do not accept the existence of those rights. But if we begin with agreement that such rights do exist (as I assume we all here do), then I don't think it makes much sense at all to suggest that the act of protecting those rights, which is what I think government should be doing, is an imposition of morality.yes, I believe my morality should be imposed on you, just as you believe your morality should be imposed on me,As I hopefully made clear above, unless you don't believe in the existence of individual rights, then I definitely do not believe my morality should be imposed on you.

"Triangles have three sides, but an isosceles triangle does not have three sides."I have difficulty considering that an apples-to-apples comparison. This may be a shortcoming in my own perception, I don't see an immediate way around that. "then I don't think it makes much sense at all to suggest that the act of protecting those rights, which is what I think government should be doing, is an imposition of morality."I think I see your point. Is there a point where protecting rights (such as appropriating funds for defense) might be seen as an imposition, moral or otherwise, and then we have to decide which has priority: avoiding imposition of any kind of morality on others via government coercion, or protecting individual rights. In a straw argument made for the point of illustration: if your right to life trumps my right to free speech, don't we have to make a choice of which right to protect primarily? And isn't that decision going to involve some sort of imposition of morality?Interesting to think about. It's making my head hurt.;)"As I hopefully made clear above, unless you don't believe in the existence of individual rights, then I definitely do not believe my morality should be imposed on you."But there is, at least, some point in abstract where you feel it would be acceptable to impose your morality on me, if my own morality (or immorality) was egregious enough. Again, we prosecute crime: the entire legal system is an imposition of morality. The moral judgements may have, at their root, protection of individual liberty, but prosecutions for theft or murder or assault generally seem to deal specifically with the enforcement of a moral set of beliefs that some people (though fringe) might not concur with.Also, in the following quote "yes, I believe my morality should be imposed on you, just as you believe your morality should be imposed on me" I intended that to be taken as a royal, "me=x, you=y" formula, which I should have made clear. My bad!

Kevin:Is there a point where protecting rights (such as appropriating funds for defense) might be seen as an imposition, moral or otherwise…As I implied in my previous, I think that taxation for any reason, even if used to protect rights, is indeed an imposition. But there is a conundrum you are right to point out: How does a government organized and dedicated to protecting rights go about financing the effort without violating those very same rights? I won't pretend to have a practical answer. Theoretically, of course, the government could allow secession. That is, anyone who did not willingly pay up for the rights protection service provided, would be left out of such protection. But obviously that isn't practical at all for lots of reasons, at least in the case of individuals. (Larger constituencies, like states, are another matter.) So, yes, to the extent that taxation is the only practical means of acquiring the funds necessary to protect rights, there seems to be a paradox in that rights must be violated to some degree in order to protect them.In a straw argument made for the point of illustration: if your right to life trumps my right to free speech, don't we have to make a choice of which right to protect primarily?Rights, coherently understood, cannot conflict. This is one reason why I am constantly asking people here to define what they mean by "rights" when some claim to a right is made, It's easy enough to claim that anything is a right (health care anyone?), but by definition if two mutually exclusive claims are made on the same thing, they cannot both be "rightful" claims. That's not to say there are no hard cases, especially in a world where knowledge is necessarily limited. But even if we cannot understand or articulate why one is a rightful claim while the other is not, it cannot sensibly be said that they are both rights.Again, we prosecute crime: the entire legal system is an imposition of morality.As I said before, unless one thinks that protection of rights is such an imposition, it doesn't have to be, and I would argue it shouldn't be.prosecutions for theft or murder or assault generally seem to deal specifically with the enforcement of a moral set of beliefs that some people (though fringe) might not concur with.Only those people who would argue that individual rights don't exist. And if they don't believe in individual rights, on what grounds could they possibly object to the imposition of the morality of individual rights upon themselves? (Now your head might really start to hurt. 😉 )

Actually I think it is too bad that you think so.I don't know what that means.Scott, how many people do you think share this vision or ideal of yours? Are there any political leaders that share your absolute minimalist ideas? Ron Paul maybe? Just curious.

"Only those people who would argue that individual rights don't exist. And if they don't believe in individual rights, on what grounds could they possibly object to the imposition of the morality of individual rights upon themselves?"You and your damned Aristotelian logic. Alright, I think I've done all the damage I can do here. Victory to Scott! You win this round. Next time . . . I'm bringing more algebraic equations to the debate.

I also heard him say on CNBC yesterday I think that he wouldn't cut SS or Medicare except as a last resort. I'm just curious if there's any politician out there who shares his views. What about Gary Johnson, that's who NoVA liked? He's a libertarian right?

lms:I don't know what that means.I assume you were talking about the ideas Kevin and I were discussing. Hence, I think it is too bad that you believe these ideas are not based in the real world.Scott, how many people do you think share this vision or ideal of yours?I suppose it depends on which vision. I would guess that a great many people would agree that the primary function of government is to protect the rights of citizens. However, regrettably few would accept, or have probably even thought about, the necessary implications of that on what government can/should do.Paul is probably the current politician who most closely understands things the way I do.

Kevin:Victory to Scott! You win this roundI'm going to have to bookmark this post. In 15 years of arguing on the net, I've never seen those words.Next time . . . I'm bringing more algebraic equations to the debate.Good idea. As I tell my colleagues at work, I'm not too good with numbers.

I saved this response to lms for a day to let it steep. I'm going to go ahead and post it even though the epic debate above continued in the meantime. Although I hav left out one part that I originally wrote (for substance and not length), I am also going to have to split it in two."I think where scott and I differ, besides on issues, is that he argues from an absolutist or more formal logical basis, universal truth if you will, and I don't believe moral issues can be resolved without the context of the problem we're trying to solve or the ramifications of the conclusion."I don't think that context or lack of context really is the difference, but I certainly agree with your recognition of a basic difference in reasoning and argument approaches. We have "discussed" or sparred over this very issue in the past back at PL, and differences like this are one important source of frustration, consternation, and anger in debate and argument. "And I wouldn't mind if one of you recognized that mine is a legitimate debating style either. You don't have to agree with it just recognize that it's accepted in some quarters at least.One thing that occurs to me is that I don't see why it should matter whether Scott or I do this. Perhaps it is nothing more than that we have known each other on line for a long time now, so our opinions and recognition mean something personally, and that certainly is a valid sentiment. A second, though, is that I'm not sure what it really means. I certainly have some familiarity with arguments that ideas are too complex always to be accounted for in linear logic, that systems of rules and logic are unavoidably incomplete and the like. There are radical schools of thought who say that reason and rationalism are little more than ideological forms of power deployed to protect privilege and power relationships, and even that the scientific method is mainly a tool of opporession and patriarchy. (I don't expect that you buy into that kind of intellectual foolishness.) But if I did not think that logically reasoned argument was superior to other approaches, I would not try to use it, and if I think that a logically correct argument defeats an illogical one, I don't know what it means to say the latter is legitimate. As I said, I think you happen to be very smart, and on the whole you tend to be more logical than not, and I most definitely respect your forensic skills and intellectual integrity.

A related point that I have promised to address in a post but have not gotten around to doing is brought to mind by your use of the term "simple minded," and that is the claim commonly made by liberals that conservatives "can't deal with complexity" and can only think in "black and white." Sometimes even conservatives buy into a form of this argument, and it comes in many forms. One of my law professors was famous (in law professor circles) for writing about "rules" versus "standards," the former being simple and strict, the latter being fuzzy and loose. You can guess which is "iberal" and which is "conservative." But I believe that precisely the opposite of the political/psychological argument is more often true. I believe that liberalism as an ideology or mindset is more simplistic and yields more simplistic arguments and positions than conservatism. So, it isn't that all liberals are simple minded, but that liberalism as an ideology and mode of thinking tends to be simplistic. Of course, I assume you would acknowledge that liberals routinely say the same of conservatives. We are painted as simple minded. I will challenge that thesis in a future post but at the moment am too busy with work to do it justice, but it was notable to me that your comment above invoked this dispute. In fact, I think your arguments to Scott and me (and Trolll — don't forget Troll!) can be interpreted in the same way, to suggest that we are simplistic. I'm really interested in this "issue" and would be interested in what others think. Of course, perhaps that means I should finish my post and make an argument about it.

I'm not going to make any arguments here just my opinions and concerns. First, I appreciate such a thought provoking post as I enjoy thinking about and discussing these types of issues. Obviously, I care about what you and scott think of me otherwise I wouldn't engage both of you for so many years. I became discouraged and disappointed with the level of discourse at the Plumline because there was never any attempt to understand or really even engage people we disagreed with. I don't think in terms of conservative or liberal being simple vs complex or vice versa. I believe we're all a little more complex than we give ourselves, or each othe,r credit for. To me the world isn't black/white/, right/wrong or good/evil. We're all of us a little of all of the above, hopefully less evil though. I generally stay away from people I believe to be inherently evil but I can't say I've come across more than a few really. I do think we sometimes argue from that perspective though, not evil necessarily, but right or wrong. I think the world is full of complex problems and the answers are not going to be easy. I really do believe in compromise and giving something up sometimes, whether it's a long held belief or a little independence for the sake of the common. I don't find it the least bit awkward or illogical for me to be able to say I don't approve of, or would ever have had or recommend abortion, but at the same time be pro choice for instance. The only way I can justify that conundrum is to be honest about the world of women and understand that for some it is a choice only they can make, and I'd prefer it be under safe conditions and not a prison offense as well as very very early in a pregnancy.I don't consider my opinions or yours to be either simple-minded or more complex, just different. I cannot debate an issue without understanding the context which is the point I was attempting to make above. And by that I don't mean in a sense of morality, I've always thought that to be a personal issue, but in the context of benefit. The physical health of our nation is important to me, and while I think there are many different ways to get there, not all of which involve confiscating money from X to give to Y, if that's where we end up in some hopefully minimal fashion, I consider it a decent trade off.I don't think every problem or grievance can or should be solved by government, I too believe the government is too intrusive in our lives, but there are times when government needs to intrude. I wish there wasn't corruption or greed, for the sake of greed, in either government or private industry, but since human nature is active in both there always will be. And honestly, when greedy politicians and greedy industry get together we have disastrous policy IMO.I don't know if that answers anything for you, I wrote it pretty fast as I really need to get busy and we're leaving on another little gambling trip later……….yay…….mindless counting but clever betting.